ArticleBMJ open2021
Cross-sectional study to develop and describe psychometric characteristics of a patient-reported instrument (PROFFIT) for measuring financial toxicity of cancer within a public healthcare system.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03473379 (Development and Validation of a Tool for Patient-reported Assessment of Cancer-related Financial Toxicity - Italy), which is not on this map. Cited by 30 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Development and Validation of a Tool for Patient-reported Assessment of Cancer-related Financial Toxicity - Italy
Who cites it
30 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Assessing Financial Toxicity in Cancer: A Global Systematic Review and Meta-Analysis Using an Asset Framework.Cancer medicine · 2026Pooled it
- A systematic review of financial toxicity measurement instruments for cancer patients based on the COSMIN guideline.Journal of patient-reported outcomes · 2026Pooled it
- Measuring the Socioeconomic Impact of Cancer: A Systematic Review and Standardized Assessment of Patient-Reported Outcomes (PRO) Instruments.PharmacoEconomics - open · 2025Pooled it
- Measuring financial toxicity in head and neck cancer: a systematic review.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2024Pooled it
- Psychometric properties of self-reported financial toxicity measures in cancer survivors: a systematic review.BMJ open · 2022Pooled it
- Constructing the scale to measure financial toxicity in cancer patients for Low-middle income countries (FT-LM) by using the modified Delphi method.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Development and validation of the subjective financial distress scale for cancer patients.BMC psychology · 2026Article
- Enhancing financial stability in healthcare through data-driven risk assessments with machine learning.Scientific reports · 2026Article
- Incorporating patients' input in the development and validation of patient-reported outcome measures in oncology: a comprehensive scoping review.Health and quality of life outcomes · 2026Review
- How recreational therapies impact physiological and psychosocial outcomes in cancer patients: a review.Oncology reviews · 2026Review
- Screening tools to assess cancer-related financial toxicity: a scoping systematic review and thematic analysis protocol.Frontiers in medicine · 2026Article
- Article
- Addressing financial toxicity for sustainable oncology care in the UK.BJC reports · 2025Article
- Assessment of financial toxicity in patients with cancer in Slovenia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Self-reported financial difficulties of colorectal cancer patients 1 year after start of treatment.ESMO open · 2025Article
- Allies not enemies-creating a more empathetic and uplifting patient experience through technology and art.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Review
- Article
- Article
- Financial Toxicity and Kidney Disease in Children and Adults: A Scoping Review.International journal of nephrology and renovascular disease · 2025Review
- Detection of Financial Toxicity in Italian Uremic Patients: A Single Center Cross-Sectional Study.International journal of nephrology and renovascular disease · 2025Article
Corrections and comments
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Authors and funding
27 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo measure and explain financial toxicity (FT) of cancer in Italy, where a public healthcare system exists and patients with cancer are not expected (or only marginally) to pay out-of-pocket for healthcare.
settingTen clinical oncological centres, distributed across Italian macroregions (North, Centre, South and Islands), including hospitals, university hospitals and national research institutes.
participantsFrom 8 October 2019 to 11 December 2019, 184 patients, aged 18 or more, who were receiving or had received within the previous 3 months active anticancer treatment were enrolled, 108 (59%) females and 76 (41%) males.
interventionA 30-item prefinal questionnaire, previously developed within the qualitative tasks of the project, was administered, either electronically (n=115) or by paper sheet (n=69). PRIMARY AND SECONDARY OUTCOME MEASURES: According to the protocol and the International Society for Pharmacoeconomics and Outcomes Research methodology, the final questionnaire was developed by mean of explanatory factor analysis and tested for reliability, internal consistency (Cronbach's α test and item-total correlation) and stability of measurements over time (test-retest reliability by intraclass correlation coefficient and weighted Cohen's kappa coefficient).
resultsAfter exploratory factor analysis, a score measuring FT (FT score) was identified, made by seven items dealing with outcomes of FT. The Cronbach's alpha coefficient for the FT score was 0.87 and the item-total correlation coefficients ranged from 0.53 to 0.74. Further, nine single items representing possible determinants of FT were also retained in the final instrument. Test-retest analysis revealed a good internal validity of the FT score and of the 16 items retained in the final questionnaire.
conclusionsThe Patient-Reported Outcome for Fighting FInancial Toxicity (PROFFIT) instrument consists of 16 items and is the first reported instrument to assess FT of cancer developed in a country with a fully public healthcare system. TRIAL REGISTRATION NUMBER: NCT03473379.
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